It is not Medicare Part A, which is hospital insurance. Plan A is a private policy that works only with Original Medicare Parts A and B. It cannot be used with Medicare Advantage.
Many people struggle here because the names sound alike and the "basic" label hides real gaps. This guide covers what Plan A pays, what it leaves to you, how premiums work, and who it suits.
Key Takeaways
- Plan A covers four core benefits but leaves the Part A deductible and skilled nursing coinsurance to you.
- It is not automatically the cheapest Medigap plan; insurer, location, and rating method drive premiums.
- Your fit depends on health needs, doctors, travel, drug coverage, budget, and enrollment rights.
What Is Medicare Supplement Plan A?
How Plan A works with Original Medicare
Original Medicare pays its share of approved Part A and Part B services first. Plan A may then pay certain remaining coinsurance or copayments under its standardized benefits.
Medigap is private supplemental insurance, not a replacement for Medicare. You keep paying your Part B premium ($202.90 monthly for most people in 2026) plus a separate Medigap premium.
The difference between Plan A, Part A, and Medicare Advantage
| Term | What it is |
|---|---|
| Medicare Part A | Original Medicare's hospital insurance |
| Medigap Plan A | A private, lettered policy that pays some costs Parts A and B leave behind |
| Medicare Advantage | A private plan that delivers Parts A and B (usually with drug coverage) instead of Original Medicare |
Medigap generally preserves access to any provider that accepts Medicare. Advantage plans often use networks.
Standardization and eligibility
Federal rules standardize Plan A benefits in most states. Massachusetts, Minnesota, and Wisconsin use different systems, so the usual lettered chart does not apply there.
You generally need both Part A and Part B. Under-65 access varies by state. Virginia requires insurers to offer at least one Medigap plan to qualifying disabled residents under 65, but that is not a guarantee of Plan A specifically. West Virginia has no under-65 offering mandate.
Provider access and policy ownership
A policy covers one person, so spouses need separate policies. With Plan A you can use doctors and hospitals that accept Original Medicare, rather than staying inside a plan network.
What Does Medicare Supplement Plan A Cover?
The four standardized Plan A benefits
Per the Medicare.gov benefits chart, Plan A pays:
- Part A coinsurance and hospital costs for up to 365 additional days after Medicare benefits run out
- Part B coinsurance or copayments
- The first 3 pints of blood
- Part A hospice coinsurance or copayments
How payment works after Original Medicare
Say you have an outpatient service that Medicare covers. Medicare pays its 80% of the approved amount first. Plan A may then pay the remaining 20% coinsurance, once your Part B deductible is met.
Plan A does not pay every bill automatically. The service must be Medicare-covered, and Medicare-approved amounts still apply.
What "basic coverage" means in practice
Plan A holds the baseline benefits every standardized plan shares. Plans B, G, N, and others add more on top.
Basic does not mean comprehensive. You still pay deductibles, skilled nursing costs, prescription drugs, dental, vision, and long-term care yourself. Check the current Medicare.gov chart and the insurer's policy documents before you enroll, since availability and state rules change.
What Plan A Does Not Cover and What It Costs
Plan A-specific gaps
Plan A generally excludes:
- The Part A deductible ($1,736 per benefit period in 2026)
- Skilled nursing facility coinsurance ($217 per day for days 21 to 100)
- The Part B deductible ($283 in 2026)
- Part B excess charges
- Foreign travel emergency care
Those two deductibles are separate amounts. Since January 1, 2020, Medigap policies sold to people newly eligible for Medicare cannot cover the Part B deductible under any plan letter.
Services generally excluded from Medigap
Medigap generally does not cover:
- Prescription drugs (Medicare Part D is the separate drug option)
- Routine dental or vision care
- Hearing aids
- Long-term care
- Private-duty nursing
Medigap and Medicare Advantage are alternatives, not a pair you can ordinarily hold together.
How Plan A premiums are priced
Private insurers set premiums. According to Medicare.gov's cost guidance, insurer, location, plan letter, rating method, and discounts all matter. Possible discounts include nonsmoker, household or married, and annual-payment options.
Three rating methods:
- Community-rated: roughly the same premium regardless of age.
- Issue-age: based on your age when you buy; it does not rise because you age, though inflation can raise it.
- Attained-age: based on your current age, so it climbs as you get older.
Fewer benefits do not guarantee a lower price. Compare the same Plan A package across carriers and ask for current quotes in your state and ZIP code.
Who Does Medicare Supplement Plan A Fit?
People who may value Plan A
Plan A can suit you if you want baseline Medigap protection and Original Medicare's provider flexibility. It may appeal when you prefer a simple supplement and can handle larger out-of-pocket costs, including the uncovered deductibles.
People who may need broader coverage
Compare broader plans if you:
- Use healthcare often and want fewer surprise bills
- Want help with the Part A hospital deductible
- Expect skilled nursing facility stays
- Travel abroad frequently
- Prefer more predictable annual costs
If you want dental, vision, hearing, or drug coverage, you need separate policies or a different approach. Plan A includes none of them.
Plan A compared with Plans G and N
| Benefit | Plan A | Plan G | Plan N |
|---|---|---|---|
| Part A deductible | No | Yes | Yes |
| SNF coinsurance | No | Yes | Yes |
| Part B excess charges | No | Yes | No |
| Foreign travel emergency | No | 80% | 80% |
| Part B deductible | No | No | No |
Plan N carries copays of up to $20 for some office visits and up to $50 for emergency room visits not leading to admission. Broader coverage is not automatically better value, because premiums and rating methods vary. KFF reports that Plan G accounts for 46% of Medigap policyholders in 2025, with Plan N at 10%.
Plan A compared with Medicare Advantage
| Factor | Original Medicare + Plan A | Medicare Advantage |
|---|---|---|
| Providers | Any that accept Medicare | Often network-based |
| Prior authorization | Usually not required | May be required |
| Extras | No dental, vision, hearing | Often included |
| Out-of-pocket cap | No standardized annual limit | Annual limit (up to $9,250 in-network in 2026) |
A practical fit checklist
Before applying, weigh:
- How often you expect to use medical care
- Whether you can absorb the Part A and Part B deductibles
- Whether your preferred doctors accept Original Medicare
- Foreign travel needs
- Separate prescription drug coverage
- Premium budget and state Medigap rules
- Open or guaranteed-issue enrollment timing
Compare total annual exposure, not just the monthly premium.
How to Enroll and Shop for Plan A
The best time to apply
Your Medigap Open Enrollment Period lasts six months, starting the first month you are 65 or older and enrolled in Part B. During it, insurers cannot refuse you or charge more based on your health. That window offers the strongest protection available.
Other events can create guaranteed-issue rights, such as your Medicare Advantage plan leaving your area or employer coverage ending. Exact rights and deadlines depend on the event.
Applying after open enrollment
Outside protected windows, insurers may use medical underwriting, charge more, limit plans, or deny you. Confirm eligibility before canceling any existing policy. Medicare gives a 30-day free look when you replace a policy, but you pay both premiums during the overlap.
Birthday rules differ by state:
| Rule | Virginia | West Virginia |
|---|---|---|
| Effective | July 1, 2025 | June 2026 |
| Window | 60 days from your birthday | 60 days from the start of your birthday month |
| Replacement | Same benefits, any insurer | Same or lesser benefits, generally same insurer |
| Requirement | Existing Medigap coverage | 24 continuous months of coverage |
Comparing policies and getting guidance
Use this shopping checklist:
- Compare identical standardized Plan A benefits
- Check premiums, rating method, and rate history
- Ask about household discounts
- Review insurer financial strength (AM Best) and complaints (NAIC)
- Read the policy documents
Arrange Part D separately if you need it. Going 63 or more days without creditable drug coverage can trigger a late penalty of 1% of the national base premium per uncovered month.
Free counseling is available through Virginia's VICAP at 1-800-552-3402 and West Virginia's SHIP at 1-877-987-4463. For people in Virginia or West Virginia, Muneris Benefits' licensed agents can help compare Medicare Supplement options and navigate Medicare transitions.
Conclusion: Is Medicare Supplement Plan A Right for You?
Plan A gives useful baseline protection alongside Original Medicare. Its limited benefits mean you should weigh uncovered costs carefully, especially the Part A deductible and skilled nursing coinsurance.
Before you enroll, compare Plan A with:
- Other Medigap plans that cover more of the gaps
- Medicare Advantage options in your area
- A separate Part D plan for prescription drugs
Use current official Medicare information and personalized guidance. Don't choose by plan letter or advertised premium alone.
Frequently Asked Questions
Which is better: issue-age or attained-age Medigap pricing?
Issue-age pricing is based on your age at purchase; attained-age rises as you get older. The better choice depends on the starting premium, expected increases, your age, location, and current insurer rates.
Who sells issue-age Medigap policies?
Availability depends on your state and carrier. Request current quotes from insurers or a licensed independent agent rather than relying on a national list.
What are the highest-rated Medigap plans?
No plan is highest-rated for everyone. Compare standardized benefits, carrier financial strength, complaint records, premium trends, and your own needs.
Can you have Medicare and Medicare Supplement (Medigap) at the same time?
Yes. Medigap is designed to work alongside Original Medicare Parts A and B. It generally cannot be used with a Medicare Advantage plan.
What is an issue-age Medigap plan?
Its premium is based mainly on the age when you buy the policy. Inflation, insurer, and state factors can still raise it over time.
What is Medicare supplemental insurance (Medigap)?
Medigap is private insurance that helps pay certain out-of-pocket costs left by Original Medicare. It does not replace Medicare and generally excludes prescription drug coverage.
